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Medications and More during pregnancy and breastfeeding

Acetaminophen (Paracetamol)

Selected References:

  • Ahlqvist VH, et al. 2024. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA, 331(14):1205–1214. 
  • Alwan S, et al. 2022. Paracetamol use in pregnancy – caution over causal inference from available data. Nat Rev Endocrinol, 18(3):190. 
  • American College of Obstetricians and Gynecologists (ACOG). 2025. Acetaminophen Use in Pregnancy and Neurodevelopmental Outcomes. Practice Advisory, ACOG. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/09/acetaminophen-use-in-pregnancy-and-neurodevelopmental-outcomes 
  • Andrade C. 2016. Use of acetaminophen (paracetamol) during pregnancy and the risk of autism spectrum disorder in the offspring. J Clin Psychiatry; 77(2):e152-4. Arneja J, et al. 2020. Association between maternal acetaminophen use and adverse birth outcomes in a pregnancy and birth cohort. Pediatr Res; 87(7):1263-1269.
  • Aselton P, et al. 1985. First-trimester drug use and congenital disorders. Obstet Gynecol 65:451-5. 
  • Aw M, et al. 1999. Neonatal paracetamol poisoning. Arch Dis Child Fetal Neonatal Ed; 81(1):F78. 
  • Baker BH, et al. 2020. Association of Prenatal Acetaminophen Exposure Measured in Meconium With Risk of Attention-Deficit/Hyperactivity Disorder Mediated by Frontoparietal Network Brain Connectivity. JAMA pediatrics, 174(11):1073–1081. 
  • Bauer AZ, et al. 2018. Prenatal paracetamol exposure and child neurodevelopment: A review. Hormones Behav 101:125-147. 
  • Baur AZ, et al. 2021. Paracetamol use during pregnancy – a call for precautionary action. Nat Rev Endocrinol, 17(12):757-766. 
  • Bornehag CG, et al. 2018. Prenatal exposure to acetaminophen and children’s language development at 30 months. Eur Psychiatry, in press. 
  • Bornehag CG, et al. 2018. Reply to: Shukla et al., Commentary on: Prenatal exposure to acetaminophen and children’s language development at 30 months. Eur Psychiatry 51:86. 
  • Brandlistuen RE, et al. 2013. Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study. Int J Epidemiol; 42(6):1702-13. 
  • Castro CT, et al. 2022. Effect of Acetaminophen use during pregnancy on adverse pregnancy outcomes: a systematic review and meta-analysis. Expert Opin Drug Saf, 21(2):241-251.
  • D’Antonio F, et al. 2026. Prenatal paracetamol exposure and child neurodevelopment: a systematic review and meta-analysis. The Lancet Obstetrics, Gynaecology, & Women’s Health; 2, e190-e198.
  • Damker P, et al. 2022. Handle with care – interpretation, synthesis and dissemination of data on paracetamol in pregnancy. Nat Rev Endocrinol, 18:191. 
  • Damkier P, et al. 2025. Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Obstetrics and Gynecology, 145(2):168–176. 
  • Feldkamp ML, et al. 2010. Acetaminophen use in pregnancy and risk of birth defects. Obstet Gynecol; 
  • Golding J, et al. 2020. Associations between paracetamol (acetaminophen) intake between 18 and 32 weeks gestation and neurocognitive outcomes in the child: A longitudinal cohort study. Paediatr Perinat Epidemiol; 34(3):257-266. 
  • Harvard Health Publishing. 2017. Acetaminophen safety: Be cautious but not afraid. https://www.health.harvard.edu/pain/acetaminophen-safety-be-cautious-but-not-afraid [Accessed 5/18]115(1):109-15. 
  • Jick H, et al. 1981. First-trimester drug use and congenital disorders. JAMA; 246(4):343-6.  
  • Li DK, et al. 2003. Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population-based cohort study. BMJ, 327(7411):368. doi: 10.1136/bmj.327.7411.368. 
  • Li D, et al. 2018. Use of nonsteroidal anti-inflammatory drugs during pregnancy and risk of miscarriage. Am J Obstet Gynecol; 219(3):275.e1-275e8. 
  • Kang EM, et al. 2009. Prenatal exposure to acetaminophen and asthma in children. Obstet Gynecol; 114 (6):1295-1306. 
  • Liew Z, et al. 2019. Use of negative control exposure analysis to evaluate confounding: An example of acetaminophen exposure and attention-deficit/hyperactivity disorder in Nurses’ Health Study II. Am J Epidemiol 188(4): 768-775. 
  • Liew Z, et al. 2014. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatr;168(4):313-20. 
  • Marsh CA, et al. 2014. Case-control analysis of maternal prenatal analgesic use and cardiovascular malformations: Baltimore-Washington Infant Study. Am J Obstet Gynecol; 211(4):404.e1-9. 
  • McElhatton PR, et al. 1997. Paracetamol overdose in pregnancy analysis of the outcomes of 300 cases referred to the Teratology Information Service. Reprod Toxicol; 11(1):85-94. 
  • Niederhoff H and Zahradnik HP 1983. Analgesics during pregnancy. Am J Med; 75:117-120. 
  • Ricci C et al. 2023. In utero acetaminophen exposure and child neurodevelopmental outcomes: Systematic review and meta-analysis. Paediatric and perinatal epidemiology, 37(5):473–484.  
  • Riggs BS, et al. 1989. Acute acetaminophen overdose during pregnancy. Obstet Gynecol; 74(2):247-53. 
  • Rosevear SK and Hope PL. 1989. Favourable neonatal outcome following maternal paracetamol overdose and severe fetal distress. Case report. Br J Obstet Gynaecol; 96(4):491-3. 
  • Smarr MM, et al. 2016. Urinary paracetamol and time-to-pregnancy. Hum Reprod, 31(9):2119–2127.  
  • Wesselink AK, et al. 2020. Association Between Male Use of Pain Medication and Fecundability. Am J Epidemiol, 189(11):1348–1359. 
  • Zafeiri A, et al. 2022. Maternal over-the-counter analgesics use during pregnancy and adverse perinatal outcomes: cohort study of 151,141 singleton pregnancies. BMJ Open, 12:e048092. 

 

 

 

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